title: Poor kidney allograft survival associated with positive B cell - Only flow cytometry cross matches: a ten year single center study.
abstract: The presence of donor specific antibody (DSA) to class 1 or class 2 HLA as detected respectively in T cell or B cell - only flow cytometry cross matches (FCXMs) are risk factors for renal allograft survival, though the comparative risk of these XMs has not been definitively established. Allograft survival and FCXM data in 624 microcytotoxicity (CDC) XM negative kidney transplants were evaluated. Short and long term allograft survival was significantly less in recipients with T(-) B(+) FCXMs (1 year, 74%, 10 year, 58%) compared to T(+) B(+) FCXMs (1 year, 84%, 10 year, 68%) and to T(-) B(-) FCXM (1 year, 90%, 10 year, 85%). Risk factors were positive FCXM, deceased donor (DD) transplantation and donor age, but not race, gender, recipient age or previous transplant. Recipients with T(-) B(+) and T(+) B(+) FCXMs were at 4.5 and 2.5 fold greater risk, respectively, of DD allograft failure compared to patients with T(-) B(-) FCXMs. The quantitative value of FCXM did not correlate with the duration of graft survival. We conclude that patients with DSA to class 2 HLA have a greater risk of early and late allograft failure compared to patients with DSA to class 1 HLA.
authors.affiliation: Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY, United States; Department of Cell Biology, SUNY Downstate Medical Center, Brooklyn, NY, United States; Transplant Immunology & Immunogenetics Laboratory, SUNY Downstate Medical Center, Brooklyn, NY, United States. Electronic address: allen.norin@downstate.edu.
authors.forename: Allen J
authors.initials: AJ
authors.lastname: Norin
authors.forename: Mary O
authors.initials: MO
authors.lastname: Mondragon-Escorpizo
authors.forename: Amarpali
authors.initials: A
authors.lastname: Brar
authors.forename: David
authors.initials: D
authors.lastname: Hochman
authors.forename: Nabil
authors.initials: N
authors.lastname: Sumrani
authors.forename: Dale A
authors.initials: DA
authors.lastname: Distant
authors.forename: Moro O
authors.initials: MO
authors.lastname: Salifu
mesh_terms: D000328:Adult; D000906:Antibodies / Q000097:blood / Q000276:immunology; D001402:B-Lymphocytes / Q000276:immunology* / Q000378:metabolism; D005260:Female; D005434:Flow Cytometry; D006084:Graft Rejection / Q000276:immunology; D006085:Graft Survival / Q000276:immunology*; D006680:HLA Antigens / Q000276:immunology*; D006650:Histocompatibility Testing / Q000379:methods; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013601:T-Lymphocytes / Q000276:immunology / Q000378:metabolism; D014019:Tissue Donors; D014184:Transplantation, Homologous
chemical_list: D000906:Antibodies; D006680:HLA Antigens
keywords: AA; AR; ATG; Black African Americans; CDCXM; DD; DS; DSA; FC; FCXM; Flow cytometry; Flow cytometry cross match; HR; IDDM; MCS; MP; SAB; acute rejection; anti-thymocyte globulin; complement dependent cytotoxicity cross matches (CDCXM); decease donor; donor specific; donor specific antibodies; hazard ratios; insulin dependent diabetes mellitus; mean channel shift; methylprednisolone; single antigen beads